Hand hygiene has always been an important element of perioperative practice and is a topic that has gained even more importance in recent years for healthcare workers. In the mid 19th century Semmelweis first noted the link between hospital acquired diseases and hand hygiene (Semmelweis 1847, NATN 2000). More recently, it has been established that continuous effective hand hygiene can significantly decrease the transmission of microorganisms, thus reducing cross infection rates of many hospital acquired infections (Pratt et al 2007).